Medical patients and doctors fear being targeted by Israeli air strikes, after a bomb killed four at Gaza health centre.

Elderly Palestinians and medical patients cannot be moved from medical centres in Gaza [Reuters]

Gaza City - Ahmad Abu Qassem’s eyes were affixed to the sky, watching through the window as Israeli war planes circled overhead. "I'm afraid to sleep because I wake up terrified of [air] strikes and bomb explosions. Sometimes Israel strikes places that are very close to us," the 11-year-old told Al Jazeera.

Ahmad has chronic hypertension, for which he receives treatment at the Rantisi Specialist Pediatric hospital in Gaza City. The hospital is 10km from the family's home in Beit Hanoun, in northern Gaza.

Despite the dangers of travelling during Israel’s continuing bombardment of the Gaza Strip, which has killed more than 172 people and injured 1,000 others, Ahmad’s mother, Eman, stays by his side at the hospital. Her other children stay at home with her husband.

I try to hide my fear and act as though nothing frightening is happening. I hug my sick child who cries in fear.

- Eman Abu Qassem, Beit Hanoun

She said she tries her best to comfort her son, but often can’t hide her own fear of the nightly Israeli bombings. "I try to hide my fear and act as though nothing frightening is happening," she told Al Jazeera. "I hug my sick child who cries in fear, but when I hear news about bombing in Beit Hanoun … my concerns about my [other] children and my husband intensify."

Since Israel’s military escalation in Gaza began, some patients have opted to receive medical care at home, fearing the hospitals may be bombed.

It also became too difficult for some families to reach their loved ones at the hospital. "I had to cut my son's treatment process due to the emergency situation," said Eman, explaining that Ahmad does not stay at the hospital permanently. "We take our son to the hospital in an ambulance, when he starts feeling bad."

Israel has justified its military campaign as an attempt to root out Hamas fighters in Gaza and stop rockets from being fired from the coastal enclave onto Israeli cities. The government has blamed Hamas for all civilian casualties in Gaza, and accused the group of using civilians as human shields and hiding weapons in civilian areas.

"Who hides in mosques? Hamas. Who puts arsenals under hospitals? Hamas. Who puts command centers in residences or near kindergartens? Hamas. Hamas is using the residents of Gaza as human shields and it is bringing disaster to the civilians of Gaza," Benjamin Netanyahu, Israel's prime minister, said on Sunday.

Early Friday morning, Israel fired two warning shots at Al-Wafa geriatric hospital, east of Gaza City. Israel claims that the hospital - which provides rehabilitation treatment for accident victims and houses the elderly - is hosting a cache of weapons.

But 30 elderly Palestinians live there, according to hospital director Basman Elashi, and cannot be moved. A group of international activists is now staying at the hospital, acting as human shields to prevent a potential bombing. Elashi credited the foreigners’ presence with saving the hospital from being destroyed. The hospital can now continue "providing health services to the patients and sheltering the elderly", he told Al Jazeera.

In Al-Zahra, seven kilometres from Gaza City, the Al-Wafa Rehabilitation Centre - a branch of the main centre - is home to 40 elderly Palestinians. According to Amer Ghbayen, the administrative supervisor of the hospital, Israel's aerial bombing campaign has made providing care to the centre’s residents very difficult.

"When Israel intensifies air strikes, namely in the night time, the elderly feel fear and horror. We try to keep these old women and men away from the windows," Ghbayen told Al Jazeera. "Meanwhile, I have my wife and children at home whom I cannot stop thinking about."

But not every medical facility has been spared. On July 11, Israel bombed a rehabilitation centre for people with disabilities in the north of Gaza, killing four people. Others were severely burned by the blast, and taken to hospital.

An Israeli air strike killed four people at a rehabilitation centre for people with disabilities in Gaza [Reuters]

Dr Mona el-Farra, the health chair of the Palestinian Red Crescent Society and Gaza director of the Middle East Children's Alliance, told Al Jazeera that this bombing has exacerbated an already difficult situation for medical professionals, who are working under extremely stressful conditions in Gaza.

"We are doing our duty... Our duty is to be there with people, but of course it has a great impact on [the medical staff] because they are working under pressure and a lack of supplies and medication," she said. "But this is not the first time that Israel does that. It is a routine experience."

Human Rights Watch reported that during its 2008-2009 offensive, dubbed Operation Cast Lead, Israel fired shells containing white phosphorous - an illegal substance that burns everything it comes into contact with - at a hospital. "The [Israeli army] repeatedly exploded it unlawfully over populated neighbourhoods, killing and wounding civilians and damaging civilian structures, including a school, a market, a humanitarian aid warehouse, and a hospital," HRW wrote.

The Gaza-based Al Mezan Center for Human Rights also accused Israel of firing at ambulance teams during the 18-day operation, killing 17 emergency workers, injuring another 50, and destroying equipment. "Medical teams were targeted as they were attempting to evacuate the wounded and the sick," the group stated.

In 2012, Israel was also accused of launching a Hellfire missile at a hospital in Gaza City. There were no casualties in the bombing, but electricity and water were cut off from the facility.

"The striking of hospitals and health facilities is a clear violation of international law," Mahmoud Daher, head of the WHO in Gaza, told Al Jazeera.

He stressed that providing a safe environment to patients is crucial to enable them to receive the health services they need. "The WHO demands all parties to spare the health centres and keep them out of the conflict," he said.

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